Individual
YULA GUADALUPE MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA, LPC
Contact information
Practice address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Mailing address
140 SOUTH HOLLY STREET, MEDFORD, OR 97501
(541) 774-8200
(541) 774-7964
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C2196
OR
Other
Enumeration date
10/15/2010
Last updated
01/27/2017
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